Newman's research as praxis: Health as expanding consciousness and living with lower extremity chronic skin wounds

The gap in knowledge about chronic wound healing and patient perception of the experience motivated this research. The purpose of the study was to answer the following questions: What is the life pattern manifested by persons who are experiencing lower extremity chronic skin wounds (CSW) and wound treatments as expressed through art and story? What are the themes expressed by life pattern manifestations across participants experiencing lower extremity CSW and wound treatments? A hermeneutic dialectic method of inquiry was utilized to apply Margaret Newman's theory of health as expanding consciousness.;The participants in this study were 10 men and eight women most of whom were of retirement age and had lived with CSW for a year or more. Data were collected via background questionnaires, two interviews and a self-expressive drawing. The initial interview focused on meaningful events and relationships from childhood through the present time and the second on further reflection and clarification. All participants gained insight and thirteen committed to new behaviors based on that insight.;Newman's research as praxis process illuminated how each participant processed a serious physical threat and integrated the experience. Reflecting across participants, five themes emerged from the data: (1) Childhood environments reflected personhood lost in the crowd. (2) Forging ahead even in the face of pain and suffering while minimizing personal threats to health. (3) A significant life event preceded his or her CSW. (4) Personal knowledge fostered a new awareness, insight, change, and integration of the wound experience. (5) Support from nurse wound care specialist and others enabled people to get through difficult times.;The study adds empirical support to Newman's theory of health as expanding consciousness and provides a new way to understand wound healing. Findings also were discussed with respect to Rogerian nursing science, developmental theory and nurse-patient relationship theories. Implications for future research, clinical practice, education, and policy were addressed.